The present invention provides a new and improved orthopedic upper extremity stabilizing device that is used as a positioning aid for supporting, restraining and/or immobilizing the upper extremity limbs or joints of a human's upper extremity by using a lightweight, formable, enveloping torso vest with extremity binders that restrict a patient's freedom of movement during pre-hospital emergency care and transport, during full medical procedures, or during the recuperation and natural healing periods. Accordingly, this invention increases the stability and immobilizes the upper extremity by ensuring prevention of unwanted patient skeletal movements which generally complicate the natural healing processes.
Heretofore, methods and devices for stabilizing and immobilizing upper extremity limbs and joints consisted of adaptations form the traditional orthopedic sling and swathe devices used when moving injured people from an accident site to a location where bone fractures and dislocations could be reduced and cast. The sling is a device which supports the upper extremity from the elbow to the wrist using the neck as a means of attachment and support. The swathe is a device that binds the upper extremity between the shoulder and the elbow against the torso when applied circumferential around the torso as a means of attachment and support. Together, the sling and swathe devices are rather primitive state-of-the-art treatment for certain upper extremity injuries that require stabilization and/or immobilization during the natural healing and recuperative periods, especially wherever casting of fractures is often difficult, impossible, or contraindicated. The sling and swathe devices do not take advantage of the newer materials that allow safer stabilization and better immobilization with fewer disadvantages.
The principle disadvantage of the aforementioned prior art is that when the swathe device is applied appropriately to prevent upper extremity skeletal movement, it is both physically and psychologically distressful to the patient. The torso is compressed by the circumferential swathe device in order to stabilize and/or immobilize the upper extremity against the torso. This can result in patient respiratory embarrassment and/or ischaemic tissue development under the swathe device. Contrarily, if the swathe device is applied too loosely in an attempt to correct the above stated disadvantage, the device can easily slip upward, coming off over the shoulder during periods of activity or sleep. A loose swathe device may also allow the injured upper extremity to move independently of the torso during body movement, thereby defeating its stabilization and/or immobilization purpose. This results in unnecessary patient pain, discomfort, and unwanted skeletal rotational movement of the humerus and forearm bones which generally complicate the natural healing processes.
Further disadvantages occur when both the swathe and sling devices are used in combination. Neither the sling nor the swathe devices are easily or accurately adjusted; both devices require multiple adjustments in order to achieve the desired stabilization and/or immobilization results, thereby creating unnecessary patient manipulation during the application process. The sling device is inherently uncomfortable on patients as a result of the entire upper extremity weight being support by the device and thereby transferred to the neck soft tissues and muscles where the sling device narrows and ties as a means of attachment, causing premature patient fatigue, unnatural posturing, sore muscles, skin contusions, ischaemia and abrasions, and general patient irritability.
Coleman, U.S. Pat. No. 4,644,939 discloses a vest-like device that the wearer applies by inserting each arm into respective sleeve portions. Adjustments of the horizontal and diagonal elastic webbing that is anchored to this vest-like device provides tension to force and guide the humerus upward along its longitudinal axis into the glenoid fossa. Coleman recommends supporting the forearm with a wrist cuff during the early treatment of the shoulder injury. The disadvantage of this type of device is that it is designed for a dislocated shoulder type injury which stabilizes the shoulder joint only, allowing the upper extremity to move independent of the torso during limited body movement, thereby reversing the immobilization characteristics necessary to prevent unwanted skeletal rotational movement of the upper extremity during long bone fractures.
In one aspect, these orthopedic brace and support inventions disclosed generally feature a vest-like construction: U.S Pat. No. 530,038, Gallegos; U.S. Pat. No. 634,429, Comly; U.S. Pat. No. 4,302,849, Margetson; U.S. Pat. No. 4,593,788, Miller. In addition, these inventions also feature stretchable or resilient type fabric construction, U.S. Pat. No. 1,129,515, Perry and U.S. Pat. No. 1,293,089, Hardy.